Contract Pharmacy Details

DIPLOMAT SPECIALTY PHARMACY
STD85260 CAN Community Health, Inc

Covered Entity Details

Entity Name

CAN Community Health, Inc

Subdivision Name

Scottsdale

Type

Sexually Transmitted Diseases

340B ID

STD85260

Entity Address

15425 N Greenway Hayden Loop
Suite A300
Scottsdale, AZ 85260

Grant Number

6 NU62PS924818-01-01

Participating Start Date

1/1/2020

Last Recertification Date

5/27/2024

Pharmacy Details

Pharmacy Name

DIPLOMAT SPECIALTY PHARMACY

Pharmacy Address

4100 S SAGINAW ST
STE D
FLINT, MI 48507-2683

Pharmacy Comments

04/09/2012 update address and name (added suite)

Contract Details

Approval Date

4/15/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/24/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

4/15/2021

340B Drug Pricing Program Database